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Background: Differentiated thyroid carcinoma (DTC), which includes the papillary and follicular variants, is a common neoplasm. DTC has a very high cure rate and is treated surgically, usually followed by ablation of the post-surgical remnant with radioiodine. Case Presentation: The case of a 68-year-old male patient who underwent a minimally invasive complete thyroidectomy on July 4, 2007 for capsulated follicular carcinoma with margins of excision exempted from neoplastic infiltration (AJCC 2002 pT2 PNX PMX) is presented. Discussion: As the patient showed the presence of a pulmonary metastasis after 11 years, the potential implications of DTC follow-up management are here summarized. Conclusions: Follow up must be continued throughout life.

Promotional trailers represent a significant trend in most entertainment sectors. However, little efforts have been done in enlightening this expressive form when related to video games. This article aims to address such a lack by analyzing game/movie (inspired by digital games) trailers as a crossroad between digital entertainment and films. The main intent is to exploit a comparative lens to uncover leading traits of short videos according to the medium that that they are portraying. Therefore, three case studies – i.e. Assassin’s Creed, Warcraft, and Overwatch – are presented and unpacked with a combination of design and semiotic tools (from Greimas’ narrative program to game heuristics) and the concepts of symmetry, dissymmetry and asymmetry advanced by Roger Caillois. Results point to a cross-media coherence between different types of trailers, and future developments are suggested for exploiting them as an informing research object.

Previous papers have already demonstrated the suitability for single-photon emission computed tomography (SPECT) tracers biodistribution studies on small animals, of a miniature gamma camera composed by a YAP:Ce scintillating array 4/spl times/4/spl times/1 cm/sup 3/ coupled to a 3-in Hamamatsu crossed-wire anode position sensitive photomultiplier (PSPMT). Some modifications have been applied to the imaging system readout in order to adapt its utilization for specific purposes (i.e. SPECT radiopharmaceutical testing) and to reduce construction costs so that a larger scale production may be feasible. In particular, the system introduced here is based on a resistive chain readout and an integrated acquisition electronics. The intrinsic performance of this new version has been analyzed and compared to the previous system, which had a single-wire readout. Results showed that the basic characteristics of the imaging system remain substantially unchanged in this simplified version, while a faster count rate is achieved. A test on a biological sample performed with the YAP camera both in single-wire and in resistive chain readout modality is also presented, which shows the system high performance in comparison to the Auger camera.

Aim. The study evaluates the therapeutic efficacy of Strontium‐89‐chloride (89Sr) and 186Re‐1,1‐hydroxy‐ethylidene diphosphonate (186Re‐HEDP) in the palliation of painful bone metastases from breast cancer. Patients and methods. Fifty patients with painful multifocal bone metastases from breast cancer entered the study and were randomized into two groups according to the radiopharmaceutical used: 148 MBq 89Sr i.v. (Group A: 25 patients) and 1406 MBq 186Re‐HEDP i.v. (Group B: 25 patients). Pain palliation was evaluated on the basis of the Wisconsin pain test improvement at two months and response was graded as complete, partial, minimal or absent. Hematological toxicity and side effects were reported according to WHO guidelines. Results. The global response rate was 84% (21/25) for 89Sr and 92% (23/25) for 186Re‐HEDP, respectively. The onset of pain palliation appeared significantly earlier in Group B (p

This study reports on a prototype single-photon emission mammograph (SPEM) dedicated to 99mTc-hexakis-2-methoxyisobutile isonitrile (MIBI) scintimammography. Main technical features are reported together with physical performance. Preliminary patient data are also reported.The SPEM detector head is composed of a CsI(T1) scintillating array coupled to a Hamamatsu R3292 position-sensitive photomultiplier tube with crossed-wire anode. The high-resolution collimator is 35-mm thick with a 1.7-mm hole diameter and a 0.2-mm septal thickness. The electronic acquisition system is composed of five integrated cards with computation based on high-speed programmable microprocessors. The readout electronics include correction maps for on-line energy correction and spatial uniformity. The small size of the detector head allows the use of mechanical breast compression to minimize detection distance and tissue scatter. After physical SPEM performance evaluation in vivo scintimammography was performed in 29 patients and was compared with a state-of-the-art Anger camera.The SPEM showed an intrinsic spatial resolution of 2 mm, an energy resolution of 23% FWHM at 122 keV and spatial uniformities of 18% (integral) and 13.5% (differential). The SPEM imaged one 0.4-cm carcinoma missed by the Anger camera and resolved as separate lumps an irregular focal uptake on the Anger camera image. The remaining cases yielded concordant results.The SPEM prototype presented in this study shows adequate physical characteristics for 99mTc-MIBI scintimammography.

Presurgical neoadjuvant chemotherapy (PSNC) is the treatment of choice for patients with locally advanced breast carcinoma (LABC). Accurate assessment of tumor response is important in planning subsequent treatments. Conventional response assessment by mammography and clinical evaluation is not fully reliable. This study evaluates the diagnostic yield of serial 99mTc-MIBI scintigraphy in the assessment of LABC response to PSNC.Twenty-nine patients affected by LABC underwent clinical, mammographic and 99mTc-MIBI scintigraphy before and after 3 cycles of FEC (500 mg/m2 5-fluorouracil, 50 mg/m2 epirubicin and 400 mg/m2 cyclophosphamide) on Days 1 and 8. Surgery was planned for 15 days after the third cycle of chemotherapy. Pathological status was obtained after surgery in all patients.Sensitivities (i.e., true-positive ratios) for a correct prediction of tumor presence after PSNC were 65% for scintigraphy, 35% for clinical evaluation and 69% for mammography. Specificities (i.e., true-negative ratios) for a correct prediction of tumor absence after PSNC were 100% for scintigraphy, 67% for clinical evaluation and 33% for mammography. Technetium-99m-MIBI uptake in this series did not correlate with P-170 expression, proliferating cell nuclear antigen, Her-2/neu oncogene protein, antihuman endothelial cell CD31 antigen and estrogenic and progestinic receptor status.Technetium-99m-MIBI scintigraphy is effective in monitoring the response to PSNC in LABC patients. Its diagnostic yield is clearly superior to clinical evaluation alone. Scintigraphy performs as does mammography in patients with negative response, but it is clearly superior in patients with positive response.

Sixty-six patients with a clinical and neuroradiological diagnosis of CNS tumors were evaluated by 111In-octreotide scintigraphy. Planar images were acquired at 2-4 and 24 hours after the injection of 111-185 MBq of 111In-octreotide (Octreoscan, Byk-Gulden). In the positive scans the tumor/non-tumor ratio was evaluated using a standard ROI method, and an uptake index (U.I.) of the lesion was determined. In vitro binding assays were performed on frozen sections from surgical specimens from 17 patients. All 32 meningiomas demonstrated a positive 111In-octreotide scan with a high U.I. Only 13 of 21 gliomas showed a positive scan, but the U.I. was significantly lower (p0.001 by "t"-test); one lymphoma showed a faint tracer uptake. All the other histotypes evaluated yielded negative scans. In all cases the receptorial pattern shown by the immunohistochemical staining technique was concordant with the scintigraphic results. 111In-octreotide scintigraphy allowed a differential diagnosis of meningioma versus other CNS tumors in 6 patients (4 neurinomas, 1 brain metastasis of melanoma, 1 lymphoma). In conclusion, 111In-octreotide scintigraphy is a promising tool to evaluate the SS receptorial pattern of CNS tumors and to increase the diagnostic specificity of conventional imaging providing useful information in selected cases for the therapeutic strategy.

Somatostatin receptors have been identified on the cellular surface of a subset of patients with small cell lung cancer (SCLC) and may be associated with a less aggressive evolution of the tumor. Moreover, medical therapy with somatostatin analogues holds promise for neoplastic growth control. We performed planar imaging in 22 patients with histologically proven SCLC at 2-4 and 24 hours after the injection of 111-185 MBq of 111In-DTPA-octreotide (Octreoscan, Byk-Gulden). Tumor uptake was observed in 19 patients in both early and late scans, while 2 patients previously treated with chemotherapy showed negative early and late scans. One patient had a positive early scan and a negative late scan. All the scintigraphic studies showed more extensive disease than expected by CT. No significant modification in tumor uptake of radiooctreotide was observed in three patients studied before and after chemotherapy. In conclusion, 111In-octreotide is a suitable radiopharmaceutical for the in vivo evaluation of the somatostatin receptors of small lung cancer. The prognostic and therapeutical implications of this nuclear technique must be further investigated, however.

SUMMARY20 subjects with Morgagni-Turner's syndrome have been extensively investigated for structural or functional abnormalities of the urinary tract. This investigation was planned owing to the observation by Morgagni, who described the first case of gonadal agenesis associated with a congenital anomaly of the kidneys, and in consideration of the embryological connection between the gonadal and the excretory « Anlagen ». Moreover, to this respect, previous investigations have been very indicative. The patients were subjected to conventional X-ray examination of the urinary tract and to radionephrography with 131 I-hyppuran and, when necessary, to renal scintigraphy with 197 Hg-neohydrin. In a group of patients inulin and PAH clearances were also determined. More than half of the patients had important abnormalities: horseshoe kidneys (5 cases), pyeloureteral duplicity (3 cases), unilateral renal aplasia (2 cases), rotation of the kidneys (1 case); seven further cases showed pyelic dilatation and hypotonia associated with frankly abnormal 131 I-hyppuran nephrograms. 3 out of 4 cases, in which clearance studies were performed, showed marked reduction of glomerular filtration rate and renal plasma flow, even though conventional urography showed no pathological change. It is evident that the urinary tract is very often abnormal in this syndrome; the abnormalities are usually structural, rarely purely functional. Thus, it seems even more justified to indicate the syndrome with both the names of Morgagni and Turner.

A theoretical analysis of the simplified radiohippuran kinetics in organism, with regard to the radiohippuran renogram evaluation, is presented. The biological processes are characterized by rate coefficients. The theoretical influence of main processes, which are involved in the kinetics, was shown on the form of radiohippuran renogram.

SummaryVarious methods were compared of studying the vascular phase of the radiohippuran renogram in man. Radioalbumin which, during the short time interval studied, does not leave the circulation, was used to evaluate the vascular capacity of the kidney region: Approximately 2.48 times more radioactivity was observed during the vascular phase of the radiohippuran renogram than during the time interval when radioalbumin was contained in the vascular bed of the kidney region. This ratio was arrived at by investigating nephrectomized subjects, thereby eliminating the effects of radioactivity in extrarenal vessels of the kidney region. The higher radioactivity over the kidney region during the vascular phase, shortly after a single radiohippuran dose has been given, could be explained by a rapid secretory process but is more likely due to the presence of a renal mechanism that concentrates hippuran. This “hippuran trapping” would occur between the “vascular” and the secretory phases. In renal function studies with radiohippuran the additional use of radioalbumin to evaluate the vascular capacity of the renal region appears to be of advantage.